| NPI | 1356534622 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRI DURHAM Office Manager 731-925-7549 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) |
| Enumeration Date | 2007-08-21 |
| Last Update Date | 2007-08-21 |